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<form id="form1" name="form1" method="post" action="">
  <p>请输入派车单号
    <label>
      <input type="text" name="xm" id="xm" />
    </label>
    <label>
      <input type="submit" name="tj" id="tj" value="提交" />
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</form>
<table  border="0"   cellpadding="1"   cellspacing="1"   bgcolor="#CEDFF7">
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  <col width="86" />
  <col width="72" span="4" />
  <tr>
    <td colspan="13"  bgcolor="#CEDFF7"  align="center"><span class="zt10">货损货差表</span></td>
  </tr>
  <tr>
    <td width="66" bgcolor="#FFFFFF"><span class="zt9">报销日期</span></td>
    <td width="66" bgcolor="#FFFFFF"><span class="zt9">派车单号</span></td>
    <td width="66" bgcolor="#FFFFFF"><span class="zt9">日期</span></td>
    <td width="66" bgcolor="#FFFFFF"><span class="zt9">车牌号</span></td>
    <td width="66" bgcolor="#FFFFFF"><span class="zt9">装货地</span></td>
    <td width="66" bgcolor="#FFFFFF"><span class="zt9">卸货地</span></td>
    <td width="66" bgcolor="#FFFFFF"><span class="zt9">货物种类</span></td>
    <td width="53" bgcolor="#FFFFFF"><span class="zt9">单价</span></td>
    <td width="92" bgcolor="#FFFFFF"><span class="zt9">破损/差数量</span></td>
    <td width="67" bgcolor="#FFFFFF"><span class="zt9"> 支出金额 </span></td>
    <td width="66" bgcolor="#FFFFFF"><span class="zt9">承运人</span></td>
    <td width="66" bgcolor="#FFFFFF"><span class="zt9">回单页数</span></td>
    <td width="74" bgcolor="#FFFFFF"><span class="zt9">备注</span></td>
  </tr>
  <tr>
    <td bgcolor="#FFFFFF"><span class="zt9">　</span></td>
    <td bgcolor="#FFFFFF"><span class="zt9">　</span></td>
    <td bgcolor="#FFFFFF"><span class="zt9">　</span></td>
    <td bgcolor="#FFFFFF"><span class="zt9">　</span></td>
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    <td bgcolor="#FFFFFF"><span class="zt9">　</span></td>
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    <td bgcolor="#FFFFFF"><span class="zt9">　</span></td>
    <td bgcolor="#FFFFFF"><span class="zt9">　</span></td>
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